Objective:

To identify potential retinal biomarkers for early detection and progression monitoring of cerebral amyloid angiopathy.

Background:

Cerebral amyloid angiopathy (CAA) encompass the pathological process of amyloid-beta affecting the arterioles, venules, and capillaries of the brain. However, early diagnosis of CAA remained ambiguous. Recently, optical coherence tomography angiography (OCTA) has emerged as a novel, non-invasive imaging modality that provides high-resolution images of retinal microvasculature and can reveal changes associated with systemic and cerebral vascular diseases.

Design/Methods:

 Patients who attended the Department of Neurology, Tongji Hospital, Wuhan City, China, from January 2014 to October 2023, diagnosed with probable CAA according to Boston version 2.0 and completed OCTA scans were included, and healthy control subjects were matched according to gender and age, the differences in OCTA-related parameters between the two groups were compared using the paired T-test or the paired non-parametric test. For those parameters that differed between the two groups, correlations between OCTA-related parameters and neuroimaging markers in the CAA group were analyzed using the Pearson test.

Results:

A total of 16 probable CAA participants and 16 healthy controls were recruited. Compared with healthy controls, the CAA group had significantly lower mean thickness of the retinal ganglion cell-inner plexiform layer (GC-IPL) (P = 0.044), fractal dimension of foveal avascular zone (FAZ) (P = 0.003), and vessel density and perfusion area of the intraretinal vascular complex, superficial vascular complex, and deep vascular complex (P < 0.05). And the vessel density and perfusion area of the inner ring of the superficial vascular complex in CAA patients were significantly negatively correlated with XIII the number of subcortical spots in the cerebral MRI (P < 0.05).

Conclusions:

The retinal characteristics become promising biomarkers in differentiating CAA, which might be validated in the future.